Why A Routine Trip To The GP Leaves Me Mentally And Emotionally Shaken
“Just relax,” he says.
I’m lying on my back, naked from the waist down as an older man in a position of authority stands over me and pries my legs further apart.
It’s an uncomfortable moment for most women.
As a survivor of childhood sexual abuse, it’s nothing less than traumatic.
It matters not the professionalism of the GP, nor the years of Cognitive Behavioural Therapy to distinguish rational fear from the irrational. The memories stored in my cells are too familiar with this scene; the fight-or-flight response activates the amygdala and all logical thoughts are overridden by the rush of adrenaline and cortisol surging through my veins.
A deluge of cold sweat seeps through my shirt and he says something to me but I cannot hear for the panic that screams inside my head and I don’t even care what he’s saying, I just want this to be over.
But it isn’t over; not yet.
“We’ll do a breast examination while you’re here,” he says. “Put the towel around your waist and take off your shirt and bra.”
He gives me a moment; turns and busies himself. My hands shake and the clasp on my bra is a deadlock and I cannot breathe for the sawdust and cardboard that must be lodged in my throat and there isn’t another towel to cover myself and I feel too exposed and grasp for my shirt but he’s there alongside me before I can reach for it again. A cold hand presses into my right breast. I stare at the ceiling and try to breathe through the hysteria I feel rising in my lungs.
There is nothing untoward in his examination yet I am not in control and this touch is not wanted and it’s too much and I am unclothed and vulnerable and overwhelmed with triggers and the only escape I have in that moment is disassociation. The switch flips; in less than one second I am mentally and emotionally no longer present, retraumatised by a simple and routine medical procedure deemed necessary to potentially save my life.
It takes me weeks to recover and find my way back to myself again.
Two years later, a reminder letter comes in the mail.
I throw it in the bin.
This is the silent re-traumatisation of victims of sexual abuse; one that is often unforeseen and rarely spoken about. But one in six Australian women have experienced sexual abuse before the age of 15. That same number have experienced sexual violence since cohabiting with a partner after the age of 15. Research has shown 72 percent of women who have experienced sexual abuse or violence either put off or never make an appointment for a Pap smear. That’s three out of four women denying themselves potentially life-saving care because the fear of being retraumatised is greater than the fear of cervical cancer.
These numbers are saddening, yet not surprising. There is little help or support to prepare women for the emotions they may experience while having a Pap smear; nor any care for those who struggle with re-traumatisation afterward. And while the Australian Cervical Cancer Foundation has created this Comfort Checklist to help overcome barriers to screening by allowing women to feel more in control and comfortable with the procedure, it isn’t enough.
There needs to be more discussion; more awareness raised, more understanding for both victims of sexual abuse and violence and the people who care for them. A fundamental misunderstanding occurs when we believe Pap smears are simply the process of a woman having a speculum inserted into her body as a standard and routine medical procedure when for victims of sexual abuse or violence, it’s far more complex than that.
More than anything, it’s the disparity of power. The struggle we have with trust, with allowing ourselves to feel vulnerable and exposed before a person of authority. It’s not being in control of our own bodies; unwanted touch in unwanted places while feeling powerless to make it stop; all too reminiscent of the trauma we have spent our lives trying to recover from.
It’s the way we are often left feeling no longer a person but merely a body; the exact way we were left feeling in the wake of sexual abuse. It is the intrusiveness and crossing of boundaries. It is the surfacing of the shame we have learned to feel about our bodies.
It’s the physical pain of the procedure we associate with the physical pain of our abuse, and the self-loathing we experience because of this -- if we can cope with sex we should be able to cope with a speculum -- even though the love, intimacy and respect in the sex lives we are capable of enjoying cannot be compared to a sterile medical procedure with an almost-stranger under fluorescent light.
It’s the anger and blame we feel toward ourselves for our own responses -- that we cannot handle a Pap smear like most normal women can. That nothing about our lives has ever been fucking normal, and never will be.
It takes me five years to make another appointment for a Pap smear; prompted only by a concern of intermittent pelvic pain. Because of my rural location, I’m forced to drive 350km to see a female GP; both costly and inconvenient. But lack of female doctors in rural locations is common and yet another blow for victims who cannot get to larger regions or cities to access appropriate care for their needs.
The experience is somewhat less traumatic; she is gentle-natured and asks about the tattoo on my ribs as she examines me; tells me it was her favourite poem in high school, we continue to talk literature. I am less triggered overall, though aware of still being quite vague and disconnected for a number of days after.
Pap smears save lives, we know this. But the throwing around of death rate statistics from cervical cancer is not enough for women who have been traumatised by sexual abuse to make an appointment to be screened. Scare tactics are futile in the face of victims who say they would rather die than put themselves through the trauma of a Pap smear ever again.
These women need to have their fears heard, understood and addressed; to feel safe and in control of their own bodies, to be able to discuss their needs and have them honoured, as in this Cervical Screening Clinic in the UK by My Body Back Project -- a specialised clinic for women who have experienced sexual violence where they can go for a Pap smear, contraceptive care and be tested for STIs in a safe environment that allows them to remain in control of the entire process.
We have a long way to go in Australia and much still needs to be done to care for the needs of victims of sexual abuse and violence. Because for every year these women are left too afraid to have a Pap smear, yet another thing is taken from those who have already lost too much.